NPI 1871895763 · live from the CMS NPI Registry
Matthew Jason Boudrero, MOT, OTR/L
Occupational Therapist in Murray, UT. National Provider Identifier 1871895763, active.
NPI record
| NPI | 1871895763 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Occupational Therapist 225X00000X |
| Practice location | 5121 Cottonwood St, Murray, UT 84107 |
| Practice phone | 801-507-7570 |
| Mailing address | 2721 Nora Dr, Salt Lake City, UT 84124 |
| Enumerated | November 27, 2010 |
| Last updated | November 27, 2010 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Occupational Therapist primary | 225X00000X | 7080114-4201 (UT) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.